Harvard and Your Head

"OCCASIONALLY I get the feeling I want to go back, because I'll never find anything so wonderful again.... You can do just anything. You've got the built-in excuse 'I'm crazy.' You can sleep all day, you can do anything you want...."

Among people who consider themselves sensitive, or philosophical, or earnest, it is fashionable to say the world is screwed up-more screwed up than they are. But few of these individuals are desperate enough-or have the courage-to make their belief real by acting at odds with the world. Those who do are called psychotic.

For the 12 to 50 Harvard and Radcliffe students who leave each year to go to mental hospitals, the trip to the other side is more often a slow, sad spiral than a sudden leap. In recent interviews, nine students who have been at McLean Hospital, a large, private, Harvard-staffed institution in Belmont, talked about freaking out-why they went, where they went, and what they found.

The kind of behavior that gets people put in mental hospitals is called sick or irrational. But conversations with these students suggest that given the interaction of genetic predisposition, personal history and the circumstances of the surroundings, "sick" actions are entirely logical. The sickness lies in the interpretation. The alienated student who cannot conform is branded with a stigma that pushes him further and further out until he reaches the hospital.

For the three Cliffies and six Harvard students who were interviewed, there were two beginnings to the way out. Some tried to shore up their crumbling insides by throwing themselves into activities or regimenting themselves mercilessly. One said, "The lack of structure that confronts most freshmen tends to make a lot of them feel pretty lousy, and in my case I overcompensated by doing a great many things. I built my own structure but it was a house of cards." Another got compulsive about his work. He couldn't go to sleep until he had laid out his notebooks, sharpened his pencils, and filled his fountain pens.

A corollary to this attitude was aggressive audacity. Offensiveness, wild hilarity, exhibitionism-one student ran naked up and down his hall. He said he consciously took on exaggerated roles, trying to find a way to break through to people. His last call for help, he says, was slashing his wrists in Graham Blaine's office. Dr. Blaine calmly sent him downstairs for sutures. The next day he was in the hospital.

The others plunged into a kind of mental ??. A Cliffie described ?? that another and in that another...." A student who characterized himself as very ?? he was becoming less and less talkative. Another student spent hours writing in his journal.

They developed an idiosyncratic way of perceiving, interpreting their surroundings so subjectively that their reactions or lack of reaction mystified onlookers. "A friend of mine failed a course he had worked his guts out on," one boy recounted. "When I heard, I roared with laughter and the people around me were shocked. They thought I was being spiteful, but really I was happy because now my friend would have to be closer to me. He had been forced to realize-as I already had-that however hard you try, it doesn't make any difference." A Cliffie said, "I wrapped myself in a cocoon and shut out the world-not because I wasn't aware of what was outside, but because it didn't count."

Their greatest problem was a lack of communication. One student said he stripped himself bare of all conventional courtesies, refusing to participate in the "trivial conversations, the crap that fills up everyone's day." He could not bring himself to make efforts to fill silences. His roommates were objects on the periphery of his consciousness.

Another student-the only one of the nine who said he had taken LSD "fairly frequently-talked at length about what made him retreat to drugs. Planes of talk range from functional, housekeeping exchanges through gossip, banter, ideological disputes, to metaphysical discussions, he said, and it is not difficult for two people to fix themselves at the same point on this scale of conversation levels. But there is another dimension to communication, where mutuality is almost impossible to achieve, he said. That is intimacy, an "ultimate intimacy not obtained by shared confessions of guilts, ambitions, Oedipus complexes, or secrets," but a mental unification analogous to sexual intercourse, a joining of thought processes so total that the listener could just as easily be the speaker. In short one gets inside the other's head.

Barred from that fashion of minds, he went on people retreat wholly into themselves or into a makeshift substitute like the frenetic sensuality of the plastic hippie or the cool of the hip intellectual. The hippie's stripped down jargon- "I dig her;" "it's a groove;" "I'm up right" -thwarts emotional expression by stylizing it, he said. "Did you ever try ending a relationship by saving 'I've got to split the scene?" The mocking wit of the hip intellectual may be worse, he said, for it skirts around honest feelings without admitting their existence. "You find it impossible to tell these cool, ??, smart people that you're unhappy." he said. By the end of freshman year, he could not speak to his roommates. "I refused to wear wire-rimmed glasses but I became an ????.

ESTRANGE ??? actions of ???? dents became overwhelmingly ?? Even those who continued to present a normal facade to friends felt increasingly isolated. Two of the Cliffies interviewed said they dated a lot. One said, "I went out so much that other girls were jealous of me. But they didn't know how lonely I was. Once I thought of myself lying asleep and I laughed. I thought, 'Poor girl, nobody cares about you and you're not even awake enough to care about yourself,'"

But people do begin to care when students make suicidal attempts. One boy said, "I went into an exam and signed a blue book and walked out. That was a sort of academic suicide gesture.... Word got back to my proctor and he said are things really bad and I said yes. He sent me to the Health Services."

ABOUT 600 undergraduates visit psychiatrists at the health services each year. Many of these are given psychological tests, but the tests are not always effective in pointing out which students are most in need of help. Eight of the students interviewed went to the health services; five were tested; only two of these tested were said to need psychiatric help. But one of those initially discharged with a clean hill of health-who later spent over a year in hospitals and saw 11 psychiatrists-said he "withheld a great deal" on the tests and in talking to his doctor.

For most of the students, some dramatic incident precipitated going to the hospital-a Cliffie screamed at her roommates for ten minutes, another student refused to take his exams, a third begged his roommate to hold his hand so he could go to sleep. By the time they got to MCLean, their feelings were violent enough that their perceptions of the hospital could not be objective. In describing it in the interviews, several said that the place was minor compared to the experiences they had.

But the ones who noticed said they could not have asked for a better setting. The scattered buildings of the century-old hospital sit atop a wooded hill, and its prep-school-like appearance is in marked contrast to the dingy institutional air of Massachusetts Mental Health, the other Harvard-staffed hospital where some students go. At McLean, new patients go through a month of "work-up" -sessions with a doctor in which the patient's case is reconstructed in minute detail. After that, a therapist is carefully selected and the patient sees him several times a week.

Several students interviewed said they were not as disturbed as most of the patients at McLean, and all but one of them stayed there less than a year. Arriving at the hospital was a shock for some. "I couldn't believe that I was actually in a mental institution," one boy said. "It was as if you had been slumming and suddenly found yourself living in a tenement."

These students were reserved and withdrawn for the first few weeks. "I was almost ashamed to talk to anyone there," the same boy said. "It would have been an admission that I was one of them." "I was too wrapped up in myself, too full of self pity to realize that there were other people around," another said.

Psychotherapy was intimidating, "First you discover that throughout your whole life you had been in one process of getting sick," one of the girls said. "Every move you made and every feeling you had had helped make you what you were now-unacceptable to the world." Another Cliffie described her therapy as "a steel claw tearing open my scabs.... During each session my hands shook and I could taste snot in my mouth." For some there was an irritating sense of disconnection, a feeling that while their parts were being microscopically examined, they were wasting their present lives and shortchanging their futures. "Once someone gave me a CRIMSON," one boy said, "and I was panic-stricken at the thought of all the time I was losing, and all the things I was missing."

The greatest frustration was the nagging uncertainty about when they would leave. "It would be even more anxiety-inducing for the doctors to tell you when you were expected to leave," one student said, "since that would become an obsession, but the fact that they left it hanging in the air made you pretty angry sometimes." Otherwise, there were no criticisms of McLean as an institution, with one exception. The student who spent the most time in hospitals and whose mind made the most harrowing trips complained that he was "vegetablized" by tranquilizers. But his experiences elsewhere suggest that his objections with McLean were primarily reflections of his state of mind at the time.

Some time after he left McLean, he said, he once more became unable to cope with Harvard and was sent at his request- "Because I knew I could leave it anytime I wanted" -to Boston State Hospital, an institution in which extremely disturbed and chronic patients are kept in custody. "I was put in a bedroom with 16 other men," he said, "screaming and urinating all over the place. I stayed in the hall and told the black attendant spook stories..." He became more and more excited and finally was put in the "box," an empty room "with cement all over, small windows with bars and an iron door. I was told to take off all my clothes... it was cold. I was not allowed to have water. I was given one blanket. There was nothing to urinate in. I screamed all night..." He left after a week and went to another hospital.

His was the extreme case. For the rest of the students interviewed, the stay in the hospital was a slow journey into the recesses of the mind. Some of them felt a massive relief on entering McLean. "Before I got to the hospital." one said. "I was constantly confronted with the accusation that I was losing my mind. The people around me could not understand actions that seemed perfectly rational to me. They wanted me to be like them, but I couldn't. I was split in two by an insoluble conflict, and I became suspicious of everyone. I always had to conceal myself. When I came to McLean, I found people who accepted everything and who were trying to help me. The attacks [of hysterical laughter] I had been having went away."

These students made friends with other patients and participated in the hospital's social life. They became part of the community that Erving Goffman describes in his book Asylums. One student still tells anecdotes about the people he met. Another said. "You could have great times there. People sat around reading I Never Promised You a Rose Garden and One Flew Over the Cuckoo's Nest. There were some great tall-tale tellers."

BUT THERE WAS one reservation. Students said that the patients never talked about each other's problems, no matter how close their friendships. "It was not that it was an unwritten law," one boy said. "You just didn't. It was irrelevant. It was the given." People could ask each other about what hospitals they had been in, or how long, but not why. "It would have destroyed a basic trust," another student said. "It would have taken away the acceptance that people need to pull themselves together."

Despite this one barrier, the same girl said, bonds do form between patients and among groups of patients,

and this phenomenon can aggravate a terrific problem in mental institutions-getting patients who have recuperated enough to be able to manage on the outside to leave the community where they feel secure and important. For Harvard students, however, there is usually a less stark contrast between a threatening outside world and a homelike hospital than that many patients face. As one boy explained, "Harvard students want to leave the hospital because they have a solid social structure to return to. In my case," he went on, "I was initially given to understand that I would stay about a year. But I left within three months. There were people I loved in Cambridge, and getting back to them was a tremendous incentive for me to get well."

All the students interviewed made it back in a relatively short time-but time enough for therapy, freedom from normal social pressures, experiments in behavior, and a lot of thinking to prepare them for dealing with other people's realities. For most the process of coming back was a series of forays into the world. One girl went to classes while spending nights at McLean. Another student worked for awhile before returning to Harvard.

Some said that the final return was the most difficult experience of their lives, "There I had been," one recounted, "having my past mistakes hashed over and analyzed and tinkered with and scrutinized. My present progress was reviewed and supervised and picked apart and weighted with tremendous significance. One extra conversation in a day, one extra act or participation, everything I did was seen by my doctor as progression or regression. The psychology of all my actions took pre-eminence over any moral value that could be imputed to them.

"So when I came back to Harvard, I was so unused to having people judge my actions objectively, according to their efficiency or morality, that I found it very hard to relate to people. I had forgotten that people found it strange when I made carbon copies of my class notes or dropped a girl I was taking out because she was beginning to care too much about me."

Re-assimilation into student life was a sticky process. One boy said his greatest problem was the time lapse. "Things that happened five months ago for my friends happened yesterday for me. I came back and my roommates were into things I knew nothing about.... I felt humiliated by never knowing what anyone was talking about." He felt threatened by the same feelings of isolation that had originally driven him to the hospital.

"I had to learn all over again how to talk to normal people," he said. "I had to force myself to look a person in the eye and forget about myself while I tried to get inside his head. I had to schedule my day's activities according to The Man's requirements rather than to the cycle of my feelings."

Only one student said people changed their estimation of him because he had been in a mental hospital. "They were very straight, very uptight people," he said. "They just did not know how to handle the situation. One of my roommates treated me very gingerly, as if he were afraid of me. The other regarded me voyeuristically, and was offensively solicitous about everything I did."

A Cliffie accused herself of selling out. "I felt that by conforming I was eradicating all that was me in my personality. By pretending to be cheerful when I wasn't or by adjusting the tenor of my conversation according to whom I was talking to, I thought I was being hypocritical. I fought all my compromises. I would stare at the person before whom I thought I was compromising myself until my eyes burned."

But eventually, she said, some of her values began to coincide with others. "And then I discovered that once you've made what you consider a compromise, it no longer torments

you. It no longer even matters, Your new worldview, your new schedule, your new friends, your new major becomes your entire concern."

Not all the students had to go through the gradual reconciliation this girl did. For some the return was swift and joyous. One boy said, "I walked up the steps to my room and pushed open the doors. All my roommates were there slapping me on the back and saying. 'Hey, man.' Right away. Before, the people I had known in high school were much realer to me than my college friends. But from then on, the characters in my dreams were the same people I saw walking around in the daytime."

The Cliffie who had been lost in her own eyes found a sharer in a whole new vision. "The day I got back," she remembered. "I walked down to the Yard and sat on the steps of Widener. It was the first warm day in such a long time. There was a boy sitting near me dressed in corduroys. He had a wise old face and the kind of arm you knew-well, you knew could cradle the head of a beloved as well as fill out income tax forms. We started talking...."

She and the others made it back and started talking. One of them wants to be a psychiatrist, and they all have heavy ideas about people and meanings. Some of them are bitter about Harvard, or about life, but they all speak with reverence about the lush garden of the mind.